At the present time, one of the most rapidly progressing areas in surgical treatment of patients is minimally invasive surgery, exemplified by laparoscopic surgery. Laparoscopic surgery, which is typically used for surgical treatment within the abdominal cavity, involves conducting the surgical procedure by use of a probe which is inserted through the abdominal wall. The probe delivers the surgical capability into the abdominal cavity. Since only a small incision needs to be made in the abdominal wall to insert the probe and gain access to the interior organs and tissues, the procedure is regarded as minimally invasive.
To gain access to the abdominal cavity, the abdominal wall is penetrated with a device called a trocar. The trocar is attached to a cannula or sheath. After penetration the trocar is withdrawn through the cannula. The abdominal cavity is then pressurized by a flow of gas delivered from an inflation pump through the cannula, and the abdominal wall expands away from the internal organs and tissues. The expansion of the abdominal wall occurs slowly and carefully so as not to damage any of the interior organs or tissues. A pressure sensor on the inflation pump senses the back pressure from the abdominal cavity and terminates the delivery of gas once the pressure reaches an upper limit. The amount of abdominal wall expansion provides good access to the interior organs.
After inflation, the probes and other surgical instruments are inserted into the abdominal cavity through a hollow interior of the cannula. A seal on the interior of the cannula contacts the probe to prevent the escape of gas from the abdominal cavity. The probes can then be manipulated from side to side due to the flexibility of the abdominal wall where the cannula penetrates it. It is typical to insert two or three cannulas in strategic locations to provide adequate access and triangulation to the inflated abdominal cavity for the surgical procedure.
A combined light source and video camera device is inserted through one of the cannulas. The interior of the abdominal cavity is illuminated and the images received by the video camera are displayed on a video monitor which is visible to the surgeon. As a result of viewing the video monitor the surgeon is able to manipulate the probes to accomplish the desired surgical effect.
After completion of the surgical procedure, the probes and cannulas are removed and the small openings made in the abdominal wall are closed. The amount of trauma experienced by the patient is considerably reduced with minimally invasive surgery, compared to the more traditional type of open surgery.
A variety of previous probes are available for use in minimally invasive surgery. However, most of these prior probes are capable of only a single use or type of functionality, for example, standard electrosurgical cutting or coagulation. A few prior art probes may be capable of limited multiple functions, such as standard electrosurgical cutting and coagulation as well as mechanical cutting or biopsy collection. Since many different types of surgical functions are typically accomplished during the minimally invasive surgery, the surgeon is usually required to remove one probe from the cannula and insert a different probe at various different stages of the procedure in order to complete the minimally invasive surgery.
Removal of one probe and insertion of another probe may have serious consequences to the patient and may, as well, create some technical difficulties. For example, if an artery or vein is cut either intentionally or accidentally during the procedure, a considerable amount of bleeding may occur into the abdominal cavity during the time while a cutting probe is removed and a standard electrosurgical coagulating probe is inserted. If the blood flow is significant, the amount of blood pooling may become substantial enough to obscure the site where the bleeding is occurring, thereby making it difficult or impossible for the surgeon to locate the bleeding site with the newly inserted probe. Furthermore the blood pool may conduct or short circuit the electrical energy applied during standard electrosurgery away from the tissue and prevent the creation and adherence of an eschar or scab in the tissue. The eschar creates the hemostasis or coagulation to stop the flow of blood. Other difficulties of a similar nature exist with respect to other types of functions which must be accomplished with single function probes used during a minimally invasive surgery.
It is with respect to this background information, as well as other information not specifically discussed here, that the present significant improvements and advancements have evolved in the field of probes for minimally invasive surgery.